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The United Dingdom - stating the bleeding obvious so you don't have to.
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Thursday, 27 October 2016

If it quacks?

Monday used to be National Sicknote Day, the day when
your local GP would glance at the full surgery waiting room but know he would
be out on house calls by mid-morning. The genuinely ill didn’t bother dragging
themselves to the local practice because it would be standing room only until the
cursory examinations were completed by the dispensation of a couple of aspirin
and an illegible signature securing a few days off for the malingerers. By the
early eighties, Self-certification for Statutory Sick Pay allowed the workshy
to diagnose their own twenty-four hour stomach bugs and freed up the doc from
providing social security to get back to medicine.

In other countries healthcare is less heavily abused,
probably because costs are born by the sick or their insurers at the point of treatment.
But in Britain, integral as it is to the welfare state, the NHS is yet another
much-abused entitlement whose heaviest users are often its lowest contributors.
If you build it they will come and at times a city-based A&E department can
resemble the temporary, volunteer-manned mission hospital set up hastily in the
aftermath of war and famine in a primitive, flyblown forgotten African state.

Whose job is healthcare really, though? Surely the care
of you and yours ought to be very much yours and theirs. And while screening
for less visible conditions and early treatment for some is undoubtedly vital,
when you delegate all responsibility for your wellbeing to people whose time is
necessarily rationed, is it any wonder that the system is regularly described
as ‘creaking at the seams’, ‘in crisis’ or that we have a matter of days to ‘save’
the NHS.

The Academy of Medical Royal Colleges has recently
identified a number of routine treatments and checks which may have little efficacy
and has called for a change of culture in how doctors prescribe treatments.
Just because your patients demand treatment it doesn’t mean they need it. The press doesn’t help here, nor does the chattering of
the Internet. No sooner does a treatment become available than some people are
in the queue for it whether it is genuinely applicable to them or not. If blood-letting
were to be reintroduced it wouldn’t surprise me to see leech surgeries springing
up in Portakabins hastily set up in hospital car parks.

The NHS was once described as ‘the envy of the world’,
although doubts have always existed over whether that was ever actually true.
But it has always struggled against the weight of demands for it to dispense quackery
for free alongside genuinely life-saving treatment. It could be argued that the
gullible demand for crackpot cures and old wives’ social psychology could be
provided ‘in the community’ by private providers. To relieve the pressures on general
practitioners maybe we should issue vouchers to be redeemed at the local witch
doctor ?

You'll just feel a little prick...

But don’t we already do that by promoting the alternative
therapy scene? Reiki, acupressure, naturopathy, aromatherapy, balneotherapy, homeopathy,
biofeedback, reflexology... candles, crystals, stones and bones,
consulting crones; when will we three meet again? And people willingly turn to
these means when conventional medicine hasn’t helped; often because ailments are
imaginary, or self-inflicted. Since the NHS was set up it has gradually dropped its
universal offerings; eyes and teeth and ears have all gone to private
providers; why not do the same for malingering too? Outsource imaginary
ailments to the imaginary cures industry and let the sickbay rangers get the treatment
they deserve.

1 comment:

You know, I am currently in the UAE working where it is a requirement for all employees to offer medical insurance as part of the ex-pat working visa.

I can see a doctor within 5 minutes of walking into a clinic, get diagnosed within 10 minutes and out the door a few minutes later.

I have to pay a maximum of 50 AED under co-pay arrangements which works out about a tenner.

I was always a strong supporter of the NHS, but having seen how it works here, then perhaps we should insist that every employee has private medical coverage as part of their terms and conditions, leaving the NHS for those who are not working.